Kodia Karishma, Huerta Carlos T, Arora Yingyot, Wickham Carey, Deshpande Amar R, Paluvoi Nivedh
Division of Colon and Rectal Surgery, Department of Surgery, University of Miami Leonard Miller School of Medicine, Miami, FL, USA.
Division of Gastroenterology, Department of Medicine, University of Miami Leonard Miller School of Medicine, Miami, FL, USA.
J Surg Case Rep. 2022 Sep 14;2022(9):rjac404. doi: 10.1093/jscr/rjac404. eCollection 2022 Sep.
Endobiliary stents placed for benign and malignant indications can spontaneously dislocate from the biliary system and migrate to the distal gastrointestinal tract. Stent migration can result in gastrointestinal perforation, with the most common locations in the sigmoid and distal colon, and may require surgical intervention. We describe the case of a 60-year-old female presenting with an ascending colonic perforation secondary to a dislodged plastic biliary stent placed for palliation of her gallbladder carcinoma. The patient was managed with a combined laparoendoscopic approach by a multidisciplinary team-gastroenterology performed an endoscopic stent retrieval and colorectal surgery identified the location of the perforation laparoscopically and performed colonic serosal repairs. The patient had an uneventful postoperative course and was discharged on postoperative day 4. This case demonstrates a novel minimally invasive laparoendoscopic approach at a high-volume academic center for the treatment of ascending colonic perforation secondary to biliary stent migration.
用于良性和恶性指征的胆道支架可能会自发地从胆道系统脱位并迁移至远端胃肠道。支架迁移可导致胃肠道穿孔，最常见于乙状结肠和远端结肠，可能需要手术干预。我们描述了一例60岁女性患者，因用于缓解胆囊癌症状而放置的塑料胆道支架移位导致升结肠穿孔。该患者由多学科团队采用腹腔镜联合内镜方法进行治疗——胃肠病学专家进行了内镜下支架取出术，结直肠外科医生通过腹腔镜确定了穿孔位置并进行了结肠浆膜修补术。患者术后恢复顺利，术后第4天出院。该病例展示了在一家大型学术中心采用的一种新型微创腹腔镜联合内镜方法，用于治疗胆道支架迁移继发的升结肠穿孔。
